1. Field of the Invention
The present invention relates generally to the field of devices for holding parts of the body in position while taking intra-operative radiographs in the surgical suite. More specifically, it relates to an apparatus for positioning the hand for antero-posterior and lateral views with minimal difficulty in reorienting the hand for each, and to isolate individual fingers for lateral views, so that the image of one finger is not superimposed over the image of an other finger. The apparatus is designed specifically for use in sterile environments where patient cooperation is not available. The apparatus includes a handreceiving channel member made of radiolucent material. The channel member has a bottom wall joined to two opposing side walls and is sized so that the back of the hand can be placed flat against the bottom wall. The apparatus also includes a block of radiolucent material, preferably formed of a foam plastic, sized to fit closely between the channel side walls, to hold any single extended finger against the channel bottom wall for lateral examination. The remaining fingers rest against a side face of the block and are curled generally toward the palm of the hand. The block and channel side walls are provided with fastening means which are preferably contact-activated, such as hook and loop fasteners or an adhesive, to removably secure the block within the channel member against the isolated finger during examination. The palm of the hand is preferably held within the channel member by securing straps. The apparatus alternatively includes a stepped support plate having a stepped edge for placing within the channel member so that a single finger rests on each step. As a result, all fingers are laterally isolated simultaneously, each finger being held extended by a tubular containing member.
2. Description of the Prior Art
There have recently been several devices for holding a hand and individual fingers of a patient in desired positions for X-ray examination. These devices have variously been expensive and complex, requiring of patient assistance unavailable during surgery, and incapable of isolating one or more fingers for lateral examination.
One prior device is that of Eaton, U.S. Pat. No. 4,674,110, issued on Jun. 16, 1987, which discloses a hand and finger X-ray positioning device. Eaton includes a base board on which the palm of the hand and forearm are placed. Securing straps anchor the forearm and wrist to the base board. Several pegs are selectively fit into a grid of holes in the base board to separate and retain fingers in a splayed configuration. A problem with Eaton is that no fingers are isolated for lateral or side view X-ray examination. If a lateral view were taken, the fingers would appear behind and in front of each other, yielding a superimposed, confused image.
Burkhalter, et al., U.S. Pat. No. 3,715,587, issued on Feb. 6, 1973, reveals a limb holder and positioner for use with a bone mineral analyzer. Burkhalter includes a platform for supporting the forearm and hand with the hand placed palm down. An adjustable abutment ear or fin extends vertically upward from the platform to protrude between the middle fingers and steady the hand. A clamp is provided which includes an upper horizontal member with a curved arm receiving recess for placing on top of the forearm, and a vertical post extends through a port in the horizontal member. A dial-headed set screw extends through the member to abut and fasten the member at a desired vertical elevation on the post, either against the arm or elevated off the arm. A beam transmissive window/slot is provided in the platform for passing gamma rays directed through the arm or hand for bone mineral content analysis. A beam directing structure extends upward from an edge of the platform and over the arm and hand. A problem with Burkhalter is that it is not designed to isolate individual fingers for lateral radiographs. Another problem with Burkhalter is that it is complex, delicate, and expensive to manufacture. As a result, it would likely have to be used for more than one patient, thereby sacrificing the guarantee of sterility.
Pirela-Cruz, U.S. Pat. No. 5,136,743, issued on Aug. 11, 1992, teaches a device for positioning the distal radioulnar joint for medical examination. Pirela-Cruz includes a platform sized to receive a forearm and hand of a patient. A pair of upright blocks are mounted on the platform and are spaced apart from each other for receiving between them a patient's wrist. A pair of pivoting gripping members extends from each block toward an opposing pair of gripping members on the other block. The gripping members engage the wrist to hold it steady for examination of the distal radioulnar joint. A post extends perpendicularly from the platform for the patient to grip, to help steady the arm and hand. A problem with Pirela-Cruz is that an anaesthetized patient could not grip the post. Another problem is that individual fingers are not isolated for lateral X-ray examination. Another problem is that the members from which Pirela-Cruz is assembled would apparently have to be heavy gauge, making the device costly.
Endura extremity positioners, illustrated on page 103 of Cone Instruments brochure, Volume 10, dated 1992-93, and page 293 of Picker Health Care Products Buyer's Guide, Volume 6, are stepped structures for fanning a patient's fingers for examination. A problem with Endura is that the stepped member cannot be reoriented to switch hands. Thus these members are not ambidextrous. Another problem is that no retaining means are provided for holding fingers of an anesthetized patient in place and extended.
It is thus an object of the present invention to provide a hand and finger positioning and posing apparatus which is sufficiently inexpensive to be disposable after examination of a particular patient is completed.
It is another object of the present invention to provide such an apparatus which is simple and easy to understand and use, and does not require patient assistance or cooperation.
It is still another object of the present invention to provide such an apparatus which will reduce operating time, exposure to radiation due to repeat X-ray examinations and physician frustration by offering a quick method of securing desired hand poritions.
It is finally an object of the present invention to provide such an apparatus which is ambidextrous.